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Published in: Advances in Therapy 5/2020

01-05-2020 | Colonoscopy | Original Research

Efficacy and Tolerability of Prucalopride in Bowel Preparation for Colonoscopy: A Systematic Review and Meta-Analysis

Authors: Sung-Wook Park, Seok-Pyo Shin, Ji Taek Hong

Published in: Advances in Therapy | Issue 5/2020

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Abstract

Introduction

Adequate bowel preparation is a vital determinant for the success of colonoscopy. However, individuals who undergo bowel preparation for colonoscopy can experience major discomfort. To solve this problem, adding prucalopride to the prepared solution may reduce intake volume, decreasing discomfort and side effects. We performed meta-analyses and systematic review of available randomized controlled trials.

Methods

Meta-analyses were conducted to evaluate the overall relative risk and 95% confidence intervals in the combined studies for the assessment of primary outcome, which is the efficacy of bowel preparation with the addition of prucalopride.

Results

Four randomized controlled trials involving 581 patients were included. When data were pooled for all patients in two non-inferiority studies, no significant difference in the quality of bowel preparation was observed between patients receiving prucalopride plus bowel preparation solution at a lower volume and those receiving the existing solution (relative risk: 0.94; 95% confidence interval: 0.86–1.03). The effects of prucalopride on acceptability, adverse events, adenoma detection rate, and polyp detection rate did not significantly differ from those of traditional solutions.

Conclusions

The combination of prucalopride and bowel preparation solution at a lower volume has similar effects on bowel preparation, and its use did not increase the occurrence of adverse effects.
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Literature
1.
go back to reference Belsey J, Crosta C, Epstein O, et al. Meta-analysis: the relative efficacy of oral bowel preparations for colonoscopy 1985–2010. Aliment Pharmacol Ther. 2012;35:222–37.PubMedCrossRef Belsey J, Crosta C, Epstein O, et al. Meta-analysis: the relative efficacy of oral bowel preparations for colonoscopy 1985–2010. Aliment Pharmacol Ther. 2012;35:222–37.PubMedCrossRef
3.
go back to reference Froehlich F, Wietlisbach V, Gonvers J-J, Burnand B, Vader J-P. Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study. Gastrointest Endosc. 2005;61:378–84.PubMedCrossRef Froehlich F, Wietlisbach V, Gonvers J-J, Burnand B, Vader J-P. Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study. Gastrointest Endosc. 2005;61:378–84.PubMedCrossRef
4.
go back to reference Brahmania M, Park J, Svarta S, et al. Incomplete colonoscopy: maximizing completion rates of gastroenterologists. Can J Gastroenterol. 2012;26:589–92.PubMedPubMedCentralCrossRef Brahmania M, Park J, Svarta S, et al. Incomplete colonoscopy: maximizing completion rates of gastroenterologists. Can J Gastroenterol. 2012;26:589–92.PubMedPubMedCentralCrossRef
5.
go back to reference Valiante F, Bellumat A, De Bona M, De Boni M. Bisacodyl plus split 2-L polyethylene glycol-citrate-simethicone improves quality of bowel preparation before screening colonoscopy. World J Gastroenterol. 2013;19:5493.PubMedPubMedCentralCrossRef Valiante F, Bellumat A, De Bona M, De Boni M. Bisacodyl plus split 2-L polyethylene glycol-citrate-simethicone improves quality of bowel preparation before screening colonoscopy. World J Gastroenterol. 2013;19:5493.PubMedPubMedCentralCrossRef
6.
go back to reference Saltzman JR, Cash BD, Pasha SF, et al. Bowel preparation before colonoscopy. Gastrointest Endosc. 2015;81:781–94.PubMedCrossRef Saltzman JR, Cash BD, Pasha SF, et al. Bowel preparation before colonoscopy. Gastrointest Endosc. 2015;81:781–94.PubMedCrossRef
8.
go back to reference Hsu CW, Imperiale TF. Meta-analysis and cost comparison of polyethylene glycol lavage versus sodium phosphate for colonoscopy preparation. Gastroinest Endosc. 1998;48(3):276–82.CrossRef Hsu CW, Imperiale TF. Meta-analysis and cost comparison of polyethylene glycol lavage versus sodium phosphate for colonoscopy preparation. Gastroinest Endosc. 1998;48(3):276–82.CrossRef
9.
go back to reference Zwas FR, Cirillo NW, El-Serag HB, et al. Colonic mucosal abnormalities associated with oral sodium phosphate solution. Gastroinest Endosc. 1996;43(5):463–6.CrossRef Zwas FR, Cirillo NW, El-Serag HB, et al. Colonic mucosal abnormalities associated with oral sodium phosphate solution. Gastroinest Endosc. 1996;43(5):463–6.CrossRef
10.
go back to reference Wong N, et al. Microscopic focal cryptitis associated with sodium phosphate bowel preparation. Histopathology. 2000;36(5):476–8.PubMed Wong N, et al. Microscopic focal cryptitis associated with sodium phosphate bowel preparation. Histopathology. 2000;36(5):476–8.PubMed
11.
go back to reference Markowitz GS, Nasr SH, Klein P, et al. Renal failure due to acute nephrocalcinosis following oral sodium phosphate bowel cleansing. Hum Pathol. 2004;35:675–84.PubMedCrossRef Markowitz GS, Nasr SH, Klein P, et al. Renal failure due to acute nephrocalcinosis following oral sodium phosphate bowel cleansing. Hum Pathol. 2004;35:675–84.PubMedCrossRef
12.
go back to reference Tan H, Liew Q, Loo S, Hawkins RJA. Severe hyperphosphataemia and associated electrolyte and metabolic derangement following the administration of sodium phosphate for bowel preparation. Anaesthesia. 2002;57:478–83.PubMedCrossRef Tan H, Liew Q, Loo S, Hawkins RJA. Severe hyperphosphataemia and associated electrolyte and metabolic derangement following the administration of sodium phosphate for bowel preparation. Anaesthesia. 2002;57:478–83.PubMedCrossRef
13.
go back to reference Marshall JB, Pineda JJ, Barthel JS, King PD. Prospective, randomized trial comparing sodium phosphate solution with polyethylene glycol–electrolyte lavage for colonoscopy preparation. Gastrointest Endosc. 1993;39:631–4.PubMedCrossRef Marshall JB, Pineda JJ, Barthel JS, King PD. Prospective, randomized trial comparing sodium phosphate solution with polyethylene glycol–electrolyte lavage for colonoscopy preparation. Gastrointest Endosc. 1993;39:631–4.PubMedCrossRef
14.
go back to reference Kim ES, Lee WJ, Jeen YT, et al. A randomized, endoscopist-blinded, prospective trial to compare the preference and efficacy of four bowel-cleansing regimens for colonoscopy. Scand J Gastroenterol. 2014;49:871–7.PubMedCrossRef Kim ES, Lee WJ, Jeen YT, et al. A randomized, endoscopist-blinded, prospective trial to compare the preference and efficacy of four bowel-cleansing regimens for colonoscopy. Scand J Gastroenterol. 2014;49:871–7.PubMedCrossRef
15.
go back to reference Yoo IK, Lee JS, Chun HJ, et al. A randomized, prospective trial on efficacy and tolerability of low-volume bowel preparation methods for colonoscopy. Dig Liver Dis. 2015;47:131–7.PubMedCrossRef Yoo IK, Lee JS, Chun HJ, et al. A randomized, prospective trial on efficacy and tolerability of low-volume bowel preparation methods for colonoscopy. Dig Liver Dis. 2015;47:131–7.PubMedCrossRef
17.
go back to reference Sharma VK, Chockalingham SK, Ugheoke EA, et al. Prospective, randomized, controlled comparison of the use of polyethylene glycol electrolyte lavage solution in four-liter versus two-liter volumes and pretreatment with either magnesium citrate or bisacodyl for colonoscopy preparation. Gastrointest Endosc. 1998;47:167–71.PubMedCrossRef Sharma VK, Chockalingham SK, Ugheoke EA, et al. Prospective, randomized, controlled comparison of the use of polyethylene glycol electrolyte lavage solution in four-liter versus two-liter volumes and pretreatment with either magnesium citrate or bisacodyl for colonoscopy preparation. Gastrointest Endosc. 1998;47:167–71.PubMedCrossRef
18.
go back to reference Adams WJ, Meagher AP, Lubowski DZ, King DW. Bisacodyl reduces the volume of polyethylene glycol solution required for bowel preparation. Dis Colon Rectum. 1994;37:229–34.PubMedCrossRef Adams WJ, Meagher AP, Lubowski DZ, King DW. Bisacodyl reduces the volume of polyethylene glycol solution required for bowel preparation. Dis Colon Rectum. 1994;37:229–34.PubMedCrossRef
19.
go back to reference Clark RE, Godfrey JD, Choudhary A, Ashraf I, Matteson ML, Bechtold ML. Low-volume polyethylene glycol and bisacodyl for bowel preparation prior to colonoscopy: a meta-analysis. Ann Gastroenterol. 2013;26:319.PubMedPubMedCentral Clark RE, Godfrey JD, Choudhary A, Ashraf I, Matteson ML, Bechtold ML. Low-volume polyethylene glycol and bisacodyl for bowel preparation prior to colonoscopy: a meta-analysis. Ann Gastroenterol. 2013;26:319.PubMedPubMedCentral
20.
go back to reference Kang SH, Jeen YT, Lee JH, et al. Comparison of a split-dose bowel preparation with 2 liters of polyethylene glycol plus ascorbic acid and 1 liter of polyethylene glycol plus ascorbic acid and bisacodyl before colonoscopy. Gastrointest Endosc. 2017;86:343–8.PubMedCrossRef Kang SH, Jeen YT, Lee JH, et al. Comparison of a split-dose bowel preparation with 2 liters of polyethylene glycol plus ascorbic acid and 1 liter of polyethylene glycol plus ascorbic acid and bisacodyl before colonoscopy. Gastrointest Endosc. 2017;86:343–8.PubMedCrossRef
21.
go back to reference Giglio MC, Luglio G, Tarquini R, Cerbone D, Bucci P, Bucci L. Role of prucalopride in treatment of chronic constipation and recurrent functional obstruction in a patient with steinert myotonic dystrophy. J Clin Gastroenterol. 2015;49:85–6.PubMedCrossRef Giglio MC, Luglio G, Tarquini R, Cerbone D, Bucci P, Bucci L. Role of prucalopride in treatment of chronic constipation and recurrent functional obstruction in a patient with steinert myotonic dystrophy. J Clin Gastroenterol. 2015;49:85–6.PubMedCrossRef
22.
go back to reference Wong BS, Manabe N, Camilleri MJC. Role of prucalopride, a serotonin (5-HT4) receptor agonist, for the treatment of chronic constipation. Gastroenterology. 2010;3:49. Wong BS, Manabe N, Camilleri MJC. Role of prucalopride, a serotonin (5-HT4) receptor agonist, for the treatment of chronic constipation. Gastroenterology. 2010;3:49.
23.
go back to reference Quigley E, Vandeplassche L, Kerstens R, Ausma J. Clinical trial: the efficacy, impact on quality of life, and safety and tolerability of prucalopride in severe chronic constipation–a 12-week, randomized, double-blind, placebo-controlled study. Aliment Pharm Ther. 2009;29:315–28.CrossRef Quigley E, Vandeplassche L, Kerstens R, Ausma J. Clinical trial: the efficacy, impact on quality of life, and safety and tolerability of prucalopride in severe chronic constipation–a 12-week, randomized, double-blind, placebo-controlled study. Aliment Pharm Ther. 2009;29:315–28.CrossRef
24.
go back to reference Emmanuel A, Cools M, Vandeplassche L, Kerstens R. Prucalopride improves bowel function and colonic transit time in patients with chronic constipation: an integrated analysis. Am J Gastroenterol. 2014;109:887.PubMedPubMedCentralCrossRef Emmanuel A, Cools M, Vandeplassche L, Kerstens R. Prucalopride improves bowel function and colonic transit time in patients with chronic constipation: an integrated analysis. Am J Gastroenterol. 2014;109:887.PubMedPubMedCentralCrossRef
25.
go back to reference Sun Z, Dong X, Zhao J, et al. Can prucalopride improve the efficacy and tolerability of colonoscopy preparation? Int J Clin Exp Med. 2017;10:9387–96. Sun Z, Dong X, Zhao J, et al. Can prucalopride improve the efficacy and tolerability of colonoscopy preparation? Int J Clin Exp Med. 2017;10:9387–96.
26.
go back to reference Hung JS, Yi CH, Liu TT, Lei WY, Wong MW, Chen CL. Does prucalopride reduce the dose of sodium phosphate in bowel preparation? A single-blind, randomized, and prospective study. Dig Dis Sci. 2019;20:294–300.CrossRef Hung JS, Yi CH, Liu TT, Lei WY, Wong MW, Chen CL. Does prucalopride reduce the dose of sodium phosphate in bowel preparation? A single-blind, randomized, and prospective study. Dig Dis Sci. 2019;20:294–300.CrossRef
27.
go back to reference Kerdsin S, Sutthivana C. Sa1073 quality of bowel preparation for colonoscopy with prucalopride plus polyethylene glycol solution: a double blind prospective randomized controlled trial. Gastrointest Endosc. 2019;89:AB164.CrossRef Kerdsin S, Sutthivana C. Sa1073 quality of bowel preparation for colonoscopy with prucalopride plus polyethylene glycol solution: a double blind prospective randomized controlled trial. Gastrointest Endosc. 2019;89:AB164.CrossRef
28.
go back to reference Choi SJ, Kim ES, Choi BK, et al. A randomized controlled trial comparing the efficacy of 1-L polyethylene glycol solution with ascorbic acid plus prucalopride versus 2-L polyethylene glycol solution with ascorbic acid for bowel preparation. Scand J Gastroenterol. 2018;53:1619–24.PubMedCrossRef Choi SJ, Kim ES, Choi BK, et al. A randomized controlled trial comparing the efficacy of 1-L polyethylene glycol solution with ascorbic acid plus prucalopride versus 2-L polyethylene glycol solution with ascorbic acid for bowel preparation. Scand J Gastroenterol. 2018;53:1619–24.PubMedCrossRef
29.
go back to reference Corleto VD, Antonelli G, Coluccio C, D'Alba L, di Giulio E. Efficacy of prucalopride in bowel cleansing before colonoscopy: results of a pilot study. World J Gastrointest Endosc. 2017;9:558–60.PubMedPubMedCentralCrossRef Corleto VD, Antonelli G, Coluccio C, D'Alba L, di Giulio E. Efficacy of prucalopride in bowel cleansing before colonoscopy: results of a pilot study. World J Gastrointest Endosc. 2017;9:558–60.PubMedPubMedCentralCrossRef
30.
go back to reference Rostom A, Jolicoeur EJ. Validation of a new scale for the assessment of bowel preparation quality. Gastrointest Endosc. 2004;59:482–6.PubMedCrossRef Rostom A, Jolicoeur EJ. Validation of a new scale for the assessment of bowel preparation quality. Gastrointest Endosc. 2004;59:482–6.PubMedCrossRef
31.
go back to reference Calderwood AH, Schroy PC III, Lieberman DA, Logan JR, Zurfluh M, Jacobson BC. Boston Bowel Preparation Scale scores provide a standardized definition of adequate for describing bowel cleanliness. Gastrointest Endosc. 2014;80:269–76.PubMedPubMedCentralCrossRef Calderwood AH, Schroy PC III, Lieberman DA, Logan JR, Zurfluh M, Jacobson BC. Boston Bowel Preparation Scale scores provide a standardized definition of adequate for describing bowel cleanliness. Gastrointest Endosc. 2014;80:269–76.PubMedPubMedCentralCrossRef
32.
go back to reference Kaminski MF, Thomas-Gibson S, Bugajski M, et al. Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative. Endoscopy. 2017;49:378–97.PubMedCrossRef Kaminski MF, Thomas-Gibson S, Bugajski M, et al. Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative. Endoscopy. 2017;49:378–97.PubMedCrossRef
33.
go back to reference Williams JE, Holub JL, Faigel DO. Polypectomy rate is a valid quality measure for colonoscopy: results from a national endoscopy database. Gastrointest Endosc. 2012;75:576–82.PubMedCrossRef Williams JE, Holub JL, Faigel DO. Polypectomy rate is a valid quality measure for colonoscopy: results from a national endoscopy database. Gastrointest Endosc. 2012;75:576–82.PubMedCrossRef
34.
35.
36.
go back to reference Sterne JA, Sutton AJ, Ioannidis JP, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ. 2011;343:d4002.PubMedCrossRef Sterne JA, Sutton AJ, Ioannidis JP, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ. 2011;343:d4002.PubMedCrossRef
37.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;151:264–9. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;151:264–9.
38.
go back to reference Briejer MR, Bosmans J-P, Van Daele P, et al. The in vitro pharmacological profile of prucalopride, a novel enterokinetic compound. Eur J Pharmacol. 2001;423:71–83.PubMedCrossRef Briejer MR, Bosmans J-P, Van Daele P, et al. The in vitro pharmacological profile of prucalopride, a novel enterokinetic compound. Eur J Pharmacol. 2001;423:71–83.PubMedCrossRef
39.
go back to reference De Schryver A, Andriesse G, Samsom M, et al. The effects of the specific 5HT4 receptor agonist, prucalopride, on colonic motility in healthy volunteers. Aliment Pharmacol Ther. 2002;16:603–12.PubMedCrossRef De Schryver A, Andriesse G, Samsom M, et al. The effects of the specific 5HT4 receptor agonist, prucalopride, on colonic motility in healthy volunteers. Aliment Pharmacol Ther. 2002;16:603–12.PubMedCrossRef
40.
go back to reference Camilleri M, Deiteren A. Prucalopride for constipation. Expert Opin Pharmacother. 2010;11:451–61.PubMedCrossRef Camilleri M, Deiteren A. Prucalopride for constipation. Expert Opin Pharmacother. 2010;11:451–61.PubMedCrossRef
41.
go back to reference Camilleri M, Beyens G, Kerstens R, Robinson P, Vandeplassche L. Safety assessment of prucalopride in elderly patients with constipation: a double-blind, placebo-controlled study. Neurogastroenterol Motil. 2009;21:1256–e117117.PubMedCrossRef Camilleri M, Beyens G, Kerstens R, Robinson P, Vandeplassche L. Safety assessment of prucalopride in elderly patients with constipation: a double-blind, placebo-controlled study. Neurogastroenterol Motil. 2009;21:1256–e117117.PubMedCrossRef
42.
go back to reference The prep is worse than the procedure Split dosing and some new liquids may make bowel cleansing needed for colonoscopy a bit easier and perhaps more palatable. Harv Health Lett. 2010;35:6–7. The prep is worse than the procedure Split dosing and some new liquids may make bowel cleansing needed for colonoscopy a bit easier and perhaps more palatable. Harv Health Lett. 2010;35:6–7.
Metadata
Title
Efficacy and Tolerability of Prucalopride in Bowel Preparation for Colonoscopy: A Systematic Review and Meta-Analysis
Authors
Sung-Wook Park
Seok-Pyo Shin
Ji Taek Hong
Publication date
01-05-2020
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 5/2020
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-020-01333-x

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